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•PSYCHOPATHOLOGY 


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THE  SPECIAL  PSYCHOLOGY  OF  DISEASE, 


DISORDER,  INSANITY,  SEX 
AND  HEALING. 


HAYDON  ROCHESTER 


707  BROADWAY  CENTRA!,  BUILDING 
424  SOUTH  BROADWAY 


PSYCHOPATHOLOGY 


THE  SPECIAL  PSYCHOLOGY  OF  DISEASE, 

DISORDER,   INSANITY,    SEX 

AND  HEALING 


BY 

HAYDON  ROCHESTER,  M.  D. 

New  York  University  and  Bellevue  Hospital  Medical  College  1902.   Poi;t=Gradu= 

ate  Medical  Courses  Berlin,   Germany.    Resident  Physician  and  Surgeon 

Rochester  City  Hospital  and  Infants' Summer  Hosptial,  Rochester,  N.  Y., 

1003=4.     Attending  Physician  Rochester  Industrial  School  end  City 

Hospital  Dispensary,  Lecturer  on  First=Aid   and  Hygiene   Me= 

chanics  Institute,  and  General  IV ecMcal  e.nd  Surfical  Practice 

Rochester,  N.  Y.,  190-'=7.'  'Ne:u>o!opy,    Psychiatry  and 

Psychanalysis,  Vanr'cfbilt  Clinic,  New  York  City, 

1907.     Neurolopist  Rochester  City  Hospital  and 

Public    Heeith    Association^    Exemiier  in 

Lunacy  aM  Sppcicdist  in-  iMe'rvoi'V  ard'i  I 

Mental    Disease,  Rochester.  N.  Y., 

1907=10.     California    State    Li= 

cense  1911 


LOS  ANGELES,  CALIFORNIA 

1915 


Copyright  1914 

BY 

HAYDON  ROCHESTER,  M.  D. 


o  «•  •         * 

••:  ; 


PSYCHOPATHOLOGY 

J><-> 

THE    SPECIAL   PSYCHOLOGY    OF   DISEASE,    DIS-O  —i 
ORDER,  INSANITY,  SEX  AND  HEALING. 

I6? 


It  is  usually  admitted  that  the  mind  rules  the 
body  and  that  most  sickness  is  mental,  but  exactly  ;'- 
how  and  why  has  never  been  made  quite  clear.  The 
purpose  of  these  pages  is  to  show  that  much  dis- 
ability is  largely  psychological,  as  well  as  curable 
and  preventable  with  this  understanding. 

Reference  is  not  made  to  injuries  and  infectious 
diseases,  which  usually  run  a  self-limited  course  to 
prompt  recovery,  but  to  the  larger  group  of  ner- 
vous, mental,  functional  and  chronic  disorders, 
which  drag  along  as  a  compromise,  of  pain,  tension, 
morbid  suggestion  and  fear,  and  which  are  in  re- 
ality merely  the  outward  manifestation  of  conflict, 
among  motives,  emotions  and  other  psychic  mech- 
anisms in  imperfect  adjustment  to  one  another. 

In  discussing  the  problem  the  first  thing  to  men- 
tion is  energy,  that  living,  indestructible,  though 
changeable  force  vibration,  which  is  constantly  ac- 
cumulating within  us,  to  be  from  time  TO  time  dis- 
charged, in  physical,  mental  or  emotional  activity. 
So  that  rather  than  mere  bodies,  we  are  in  reality 
vehicles  of  energy,  for  whom  a  healthy  balance 


er  ft* 


:  •  !•"'':  \     PSVCH 


between    accumulation    and    expenditure    is    neces- 
sary to  well-being. 

Psychology  deals  with  energy  in  operation  men- 
tally, and  to  understand  the  psychology  of  disease 
and  disorder  one  must  become  acquainted  with  cer- 
tain psychological  mechanisms,  such  as  suggestion, 
distraction,  repression  and  the  like,  and  realize  the 
absolute  unity  of  the  organism  as  a  whole.  The 
mind  and  the  body  are  not  separate  things,  but  are 
merely  differing  aspects  of  the  one  unified  self, 
changes  in  one  of  whose  aspects  are  reflected  in  all 
the  others. 

For  example,  the  emotions  of  fear  and  anxiety 
paralyze  and  contract  the  mind.  This  condition  is 
then  conducted  to  all  parts  of  the  body  and  con- 
traction becomes  the  order  in  every  cell  and  struc- 
ture. Because  of  differing  susceptibility  this  con- 
traction when  persistent  may  show  in  the  bronchial 
tubes  as  asthma,  in  the  muscles  of  the  back  as  pain 
along  the  spine,  in  the  stomach  as  dyspepsia,  in  the 
tissues  of  the  kidney  as  Bright's  disease,  or  it  may 
warp  the  general  state  of  being  with  some  nervous 
affection,  or  even  mental  derangement.  On  the 
other  hand,  real  disorder  in  a  bodily  part  sends  its 
distress  to  the  mind,  whose  consequent  strain  of 
suffering  and  fear  can  keep  returning  to  the  part. 


PSYCHOPATHOLOGY 

even  when  it  might  recover,  and  form  a  viscious 
circle  of  chronic  disability  which  persists  indefinite- 
ly until  the  mental  strain  is  relieved. 

This  intimate  association  between  mind  and  body 
is  well  attested  by  such  obvious  illustrations  as  the 
reddening  of  the  face  in  shame  or  embarassment, 
disturbance  of  heart-action  by  fear,  nausea  pro- 
duced by  a  repulsive  thought,  obstructed  liver  and 
constipation  from  anxious  constraint,  excessive  kid- 
ney action  from  feverish  excitement,  and  numerous 
others,  to  say  nothing  of  the  corresponding  re- 
covery when  the  distressing  emotion  fades.  Such 
purely  psychological  elements  as  emotions  then,  by 
their  definite  influence  on  the  responsive  tissues, 
are  seen  to  determine  physical  conditions,  but  to 
fully  explain  their  responsibility  for  continuous 
disease  and  disorder,  additional  mechanisms  must 
be  considered. 

The  first  of  these  is  suggestion,  or  that  process 
by  which  an  idea  is  implanted  with  sufficient  power 
to  insure  response.  Suggestion  is  intensified  bv 
repetition,  and  by  reinforcement  from  other  sources 
of  similar  suggestion.  It  is  a  law  to  which  all  arc 
amenable,  and  is  most  effective  when  arising  from, 
or  attended  by  physical  sensation,  which  means 
that  when  we  feel  pain  we  arc  caused  to  believe 


6  PSYCHOPATH OLOGY 

something-  wrong",  which  is  true,  but  suggestion 
may  tend  to  exaggerate  the  sensation,  and  give  it 
undue  significance.  Indigestion  for  example,  causes 
excess  of  gas  in  the  stomach,  which  by  pressure  on 
the  heart  can  disturb  its  action  and  give  the  sug- 
gestion of  heart  disease.  Treatment  directed  to  the 

o 

heart  would  then  but  reinforce  this  suggestion,  as 
would  also  the  repetition  of  the  heart  symptoms 
caused  by  the  neglected  stomach. 

An  important  mechanism  favoring  suggestion  is 
that  of  distraction,  or  the  production  of  a  disturbed, 
preoccupied,  or  even  resistless  mental  state  by  some 
undercurrent  of  feeling,  a  shock,  an  injury,  or  per- 
haps deliberate  mental  fixation,  which  narrows  or 
absorbs  the  reasoning  power,  and  permits  the  sug- 
gestion to  enter  and  take  root.  If  the  subject  hav- 
ing indigestion,  for  instance,  were  under  great  ner- 
vous strain  from  worry,  his  mind  so  distracted 
would  not  be  free  to  discount  the  sensations  of 
heart  disturbance  as  merely  2'as  in  the  stomach,  and 

•/         t.9 

the  more  adverse  suggestion  of  heart  disease  would 
then  be  absorbed  and  manifested. 

Moreover  a  mechanism  of  defense  may  act,  lead- 
ing one,  when  hard  pressed,  to  accept  a  suggestion 
just  as  it  comes,  as  a  way  of  escape  from  some  ob- 
ligation or  predicament,  and  perhaps  unconscious- 


PSYCHOPATHOLOGY  7 

ly,  but  when  these  mechanisms  operate,  the  result- 
ing disorder  is  liable  to  settle  down  into  the  inertia 
of  habit,  for  with  a  line  of  lessened  resistance  es- 
tablished, the  original  sensations  will  doubtless  re- 
cur, and  continue  to  affect  both  mind  and  body. 
It  may  even  be  inferred  that  the  indigestion  in  the 
first  place  was  merely  due  to  worry,  perhaps  ag- 
gravated by  some  dietary  indiscretion,  and  would 
have  been  entirely  transitory  except  for  the  other 
mechanisms.  Countless  other  examples  affecting 
any  combination  of  organs,  and  with  varying  un- 
dercurrents of  mixed  motives  will  readily  suggest 
themselves. 

A  further  determining  mechanism  is  that  of  re- 
pression, which  again  brings  out  the  importance  of 
energy.  The  study  of  a  psychological  unit,  namely 
a  single  elementary  experience,  such  as  touching 
the  desk  with  the  palm  of  the  hand,  will  illustrate. 
This  experience  consists  of  motion  of  the  hand,  first 
descending  and  then  arrested  by  the  desk-top,  in 
which  process  the  expended  energy  is  transmitted 
to  the  nerves,  and  thence  to  the  mind  as  a  sensation. 
Should  the  hand  be  brought  down  with  violence, 
one  would  receive  a  surcharge  of  energy  or  feeling, 
and  be  thrown  out  of  equilibrium  into  a  state  of 
tension,  attended  by  tingling  nerves  and  general 


PSYCHOPATHOU  >GY 

strain,  which  would  last  some  time,  unless  one  went 
through  reactions  to  discharge  the  surcharge,  such 
as  rubbing  the  hand  or  uttering  some  expletive, 
when  the  tension  would  relax  and  relief  at  once  be 
felt.  Hut  for  some  motive  one  might  choose  to  sup- 
press all  reaction  and  maintain  perfect  composure, 
when,  if  there  were  many  repetitions  of  the  blow, 
a  limit  to  undisturbed  endurance  would  be  reached, 
and  the  strain  would  be  reflected  in  one's  general 
condition.  In  other  words,  the  energy  of  the  blow 
is  received  bv  the  organism  as  an  impact  or  charge 
producing  excessive  tension,  which  accumulates  on 
repetition,  and  if  not  discharged  by  reaction,  puts 
one  under  great  strain  to  contain  it. 

Every  experience  means  the  delivery  into  one  of 
a  definite  volume  of  energy,  and  the  same  lawr  holds 
in  our  more  complex  and  highly  organized  experi- 
ences. The  shock  of  a  true  bereavement,  for  in- 
stance, lays  upon  us  a  weight  of  crushing  force, 
which  holds  and  wears  us  down,  and  distorts  our 
normal  state  of  being,  just  so  long  as  we  retain  it 
by  repressing  all  emotion,  and  begins  to  lighten  and 
release  us  in  proportion  as  we  vent  our  feelings,  and 
permit  the  reactions  which  restore  equilibrium. 
Such  a  volume  ot  repressed,  held-in  teeling  consti- 
tutes a  complex,  or  mental  sore,  which  makes  for 


PSYCHOPATHOLOGY  9 

distraction  and  exposes  us  to  a  train  of  pathological 
events  similar  to  the  one  outlined,  whereas  react- 
ing adequately,  in  response  to  the  urgent  pressure, 
we  retain  no  vulnerable  spot,  but  return  to  normal 
balance. 

It  might  be  objected  that  it  is  not  well  to  keep 
dwelling  upon  one's  troubles  either,  which  of  course 
is  true,  for  it  merely  aggravates  them,  and  leads  to 
the  disintegrating  habit  of  self-pity.  But  if  a  par- 
ticular train  of  lament  or  complaint  is  being  carried 
beyond  due  limits,  it  is  because  it  is  used  as  a  par- 
tial or  substitute  vent  for  deeper  trouble  that  is  cov- 
ered over,  and  therefore  all  the  more  in  need  of  dis- 
covering and  discharging.  For  the  feeling  that  is 
fermenting  in  these  submerged  mental  complexes 
reacts  on  the  bodily  tissues  and  undergoes  conver- 
sion into  physical  symptoms,  so  that  obstinate  phy- 
sical nausea,  for  instance,  can  be  due  entirely  to  a 
suppressed  mental  repugnance,  and  will  disappear 
completely  upon  discharge  of  the  underlying  com- 
plex. 

Probably  four-fifths  of  all  human  disability  is 
constructed  out  of  just  such  mechanisms  and  noth- 
ing else,  but  since  they  usually  develop  unconscious- 
ly, or  subconsciously,  outside  the  usual  conscious 


10  PSYCHOPATHOLOGY 

ran^e  of  the   victim,  we   should   now   consider  the 

o 

subconscious. 

The  subconscious  is  not  another  mysterious  or 
separate  mind,  but  is  merely  that  major  portion  of 
the  entire  self,  which  at  a  given  moment  is  out  of 
the  immediate  focus  of  conscious  attention,  although 
explorable  by  it,  and  in  which  are  enacted  all  those 
usually  unnoted,  automatic  or  reflex  activities,  such 
as  breathing,  heart-beat,  habitual  movements,  etc., 
our  more  delicate  reactions  to  situations  and  people, 
the  subtle  impressions  of  telepathy  and  the  like,  and 
the  insidious  suggestions  of  disease,  in  fact  all  the 
functions  of  being  except  those  with  which  one 
happens  to  be  consciously  concerned  at  the  time. 
These  subconscious  processes,  which  comprehend 
all  the  forces  of  the  individual,  and  are  made  up  of 
the  entire  mass  of  impressions  and  reactions  under- 
gone by  the  organism  as  a  whole,  are  therefore  more 
powerful  than  those  actuated  by  mere  reason,  which 
can  only  use  what  may  be  put  into  actual  formula. 

The  ability  to  direct  attention  is  largely  under 
control  of  the  will,  and  a  normal  individual  is  able  to 
focus  his  consciousness  on  any  portion  of  himself  or 
his  environment,  and  to  know  it  as  it  actually  is. 
One  may  also  if  so  disposed,  withdraw  conscious- 
ness from  a  given  area,  and  ignore  the  reactions 


PSYCHOPATHOLOGY  11 

taking  place  in  it,  when  they  will  take  place  sub- 
consciously. But  since  the  entire  self  is  in  relation 
with  itself  and  with  the  whole  environment,  and  in- 
terreactions  continually  occur,  this  partial  oblivion 
can  only  be  achieved  by  forcibly  narrowing  the 
range  of  consciousness  so  as  to  exclude  the  repug- 
nant portion,  which  then  becomes  divided  off,  at  the 
expense  of  the  whole,  for  the  reception  and  carrying 
on  of  the  repudiated  impressions  and  reactions.  If 
these  impressions  and  suppressed  reactions  persist, 
more  and  more  of  the  self  will  be  appropriated  for 
their  requirements,  until  this  split-off  portion  may 
become  strong  enough  to  pursue  an  almost  inde- 
pendent existence,  dividing  the  self  in  a  manner 
which  manifests  as  dual  or  dissociated  personal- 
ity. Persons  so  affected  hear  voices  when  none 
speak,  some  reaction  in  the  secondary  self  making 
itself  mentally  audible  as  a  message  from  without, 
and  inducing  various  conflicts,  with  aberration  of 
conduct,  or  literal  unbalancing  of  mind. 

A  grievous  disillusionment,  for  instance,  might 
be  resisted  and  rejected  so  intensely  as  to  result  in 
such  dissociation,  for  assuming  that  the  grounds 

o  o 

for  it  are  genuine,  they  will  affect  the  subject  ac- 
cordingly, even  if  only  subconsciously,  then  divide 
the  self  as  shown  above,  and  if  persistent  induce 


12  PSYCHOPATHOLOGY 

some  outcry,  in  the  form  of  visions,  warnings  or 
commands,  which  result  in  acts  that  seem  prepos- 
terous or  insane. 

P>nt  all  such  states  are  inherently  artificial,  with- 
out endurance  of  their  own,  and  would  tend  to  fade 
and  clear  up,  unless  renewed  from  the  deeper 
source  of  motive,  instinct  or  desire,  subdivided  into 
numerous  motives,  the  stress  of  whose  conflict  con- 
tinues the  symptoms. 

In  other  words  these  abnormalities  constitute 
nothing  more  than  a  working  compromise  of  con- 
flicting motives.  Or  stated  more  technically,  they 
are  but  the  outward  resultants  of  contending  forces, 
operating"  in  terms  of  the  described  mechanisms. 
We  give  to  these  forces  the  name  of  motives,  al- 
though they  ultimately  resolve  themselves  into  a 
single  one,  the  urge  of  being,  which,  however,  best 
lends  itself  to  analysis  as  a  trinity,  comprising  the 
motives  or  instincts  of  self-preservation,  self-pro- 
jection and  self-respect. 

The  first  includes,  in  addition  to  self-preservation, 
the  desire  to  live  well,  in  the  best  possible  circum- 
stances and  to  have  some  of  the  good  things  of  life, 
thus  embracing  acquisitiveness  in  various  forms. 
The  second,  self-projection,  comprehends  the  sex 
urge,  love  motive  and  social  instinct,  wherebv  we 


PSYCHOPATHOLOGY  13 

mate,  expand  our  feelings  and  seek  to  mingle  with 
our  fellow  men.  This  also  includes  the  love  of 
liberty,  and  the  urge  toward  self-expression.  The 
third  motive,  that  of  self-respect,  comprehends  hon- 
or, decency,  virtue,  pride,  loyalty,  adherence  to  one's 
code,  striving  for  an  ideal,  desiring  to  stand  well 
and  to  save  one's  face. 

The  possibilities  of  discord  in  one  lacking  wis- 
dom are  obvious.  Passion  is  never  at  peace  with 
virtue,  and  honor  has  always  to  fight  greed  of  gain, 
though  the  conflicts  at  fault  are  usually  far  more 
subtle.  There  is  also  the  reverse  phase,  what  might 
be  called  negative  motives,  such  as  considerations 
of  prudence,  shame  or  fear,  as  well  as  opposing  de- 
sire, or  not  to  do,  not  to  be,  not  to  have  what  is. 

Out  of  these  constant,  conflicting,  or  thwarted 
motives,  and  the  emotions  they  engender,  proceeds 
the  energy  which  maintains  the  mechanisms  and 
perpetuates  disease,  that  is  until  the  motives  are 
harmonized,  or  intelligently  directed,  when  order, 
well-being  and  progress  supervene.  One  marrying 
merely  for  advantage  subserves  but  a  single  instinct, 
that  of  acquisition  or  pride.  The  others  atrophy, 
ferment  or  putrefy,  with  results  to  correspond,  un- 
less the  art  of  wholesome  transmutation  is  acquired. 

Motives  get  their  cast  in  the  evolutional  period  of 


14  PSYCIIOPATHOLOGY 

childhood,  when  impressions  are  made  and  reactions 
take  place  in  sensitive  soil,  and  the  primitive  im- 
pulses, and  stresses  of  restraint,  reacting  upon  the 
particular  temperament,  determine  the  manner  of 
adjustment  to  all  that  is  to  follow.  At  this  time 
predilections  are  acquired  and  standards  absorbed 
which  unconsciously,  and  later  forgotten,  color  and 
determine  our  actions  and  reactions  all  through 
life.  And  since  life  itself  is  so  complex,  and  loaded 
with  rigorous  buffets,  it  is  no  wonder  that  some  of 
us  follo\v  the  line  of  least  resistence  and  compromise 
on  disease. 

But  it  is  not  scientific  to  generalize,  for  every  case 
is  distinctly  individual  and  the  problem  is  different 
for  each  one,  although  the  abnormal  conditions  re- 
sulting usually  fall  into  one  of  the  three  main  groups 
of  physical,  nervous  or  mental  disorder  and  perhaps 
should  now  be  catalogued  in  that  way. 

In  the  physical  category,  upon  the  basis  outlined, 
\ve  may  have  affections  of  any  organ  or  part  what- 
soever, mental  and  emotional  tension,  perhaps  un- 
realized, fastening  upon  some  otherwise  transitory 
ailment,  and  with  the  automatic  response  of  the 
tissues  involved,  built  up  unconsciously  into  any 
form  of  disordered  function,  even  to  the  point  of 
actual  lesion  or  disease. 


PSYCHOPATHOLOGY  15 

By  way  of  making  a  list  we  could  mention  various 
forms  of  head-ache  and  neuralgia,  eye-strain,  catahr- 
ral  conditions,  affections  of  the  nose,  ears  and  throat, 
bronchial  and  pulmonary  complaints,  heart  and  cir- 
culatory disturbances,  stomach  and  digestive  diffi- 
culties, liver  obstinacies,  intestinal  disorders  both 
active  and  passive,  affections  of  the  genito-urinary 
system,  many  paralytic  and  spasmodic  difficulties, 
including  disturbances  of  gait,  of  muscular  control 
and  of  the  joints,  as  well  as  disorders  of  sensation 
and  skin  affections,  to  say  nothing  of  those  vague, 
unusual,  unclassified  ailments  of  wdiich  there  seems 
to  be  only  one  of  its  kind.  Diabetes  is  often  estab- 
lished upon  such  a  combination  of  mechanisms,  as 
well  as  manv  forms  of  rheumatism.  Some  cases  al- 

•/ 

so  of  cancer  and  tumor  have  such  a  foundation,  built 
up  from  some  chance  blow  or  injury,  as  well  as  ac- 
tual tuberculosis. 

In  the  category  of  nervous  disorders  we  place 
those  ailments  in  which,  although  there  is  no  struc- 
tural change  in  any  bodily  part,  there  yet  exists 
most  trying  disability.  A  list  would  include  neu- 
rasthenia or  nerve  weakness,  though  the  nerves 
themselves  are  not  affected,  nervous  depression  and 
nervous  irritability,  anxiety,  phobias  or  fears,  ex- 
treme sensitiveness,  painful  self-consciousness,  in- 


16  PSYCHOPATHOLOGV 

ability  to  make  decisions,  diminished  will-power  or 
power  of  concentration,  defective  memory,  insom- 
nia, somnambulism,  persistent  bad  dreams,  emo- 
tional instability,  hysteria,  stammering,  obsession 
or  unreasonable  impulse  or  thought,  habits,  and  dis- 
sociation of  personality  with  lapse  or  loss  of  the 
self. 

There  is  also  another  group  of  derangements 
which  fall  short  of  absolute  mental  aberration,  and 
wherein  the  subject  seems  otherwise  quite  normal, 
yet  is  none  the  less  dominated  by  extremely  cun- 
ning, cruel  or  criminal  tendency,  alcoholic  or  drug 
addiction,  or  perversion  of  the  sex  instinct.  Such 
conditions  exist  invariably  because  of  the  stresses 
indicated,  except  when  they  are  the  result  of  definite 
deficiency. 

Under  the  grouping  of  true  mental  aberration, 
commonly  called  insanity,  or  technically  psychosis, 
we  place  here  only  the  psychological  forms,  and 
omit  those  due  to  congenital  defect  or  actual  dam- 
age to  the  brain.  There  seem  to  be  three  main  va- 
rieties, mania  or  excessive  mental  excitation,  often 
showing  outbursts  of  violence,  melancholia  or  ex- 
treme mental  depression,  sometimes  attended  b\ 
self-destroying  or  mutilating  tendencies,  and  de- 
mentia or  marked  mental  reduction.  Of  these  the 


PSYCHOPATHOLOGY  17 

first  two  are  prone  to  alternate  in  the  same  individ- 
ual, and  all  are  usually  attended  by  delusions,  illu- 
sions and  hallucinations.  There  is  also  the  large 
paranoid  group,  characterized  by  special  delusions 
of  self-aggrandizement  and  persecution,  in  connec- 
tion with  which  there  is  much  suspicion  and  vindic- 
tiveness.  It  should  also  be  remarked  that  these 
states  do  not  always  exist  in  pure  type,  but  more 
often  as  mixtures  or  blends,  shading  into  one  an- 
other. In  fact  this  exterior  differentiation  is  merely 
'the  result  of  previous  efforts  to  classify,  and  if  pos- 
sible assign  a  physical  cause  to  each  one,  whereas 
more  recent  understanding  of  the  conflicts,  among 
motives,  emotions  and  other  psychic  mechanisms 
makes  their  nature  clearer. 

But  in  order  to  account  for  them  fully  we  must  re- 
vert back  even  as  far  as  infancy.  The  baby  is  a 
complete  egotist,  moved  for  the  first  months  of  his 
life  only  by  impulses  connected  with  his  own  needs 
and  pleasure,  which  for  the  first  year  is  as  it  should 
be,  when  there  should  begin  to  be  inculcated  reason- 
able discipline  and  consideration  of  others.  But  he 
may  have  too  indulgent  proprietors,  or  seem  so  self- 
willed  that  one  hesitates  to  cross  him,  when  his  ego 
will  flourish  unduly  and  fill  his  entire  horizon.  In- 
stead of  expanding,  his  nature  will  then  grow  in- 


18  PSYCHOPATHOLOGY 

ward,  preventing  appreciation  of  his  environment, 
and  causing  him  to  hold  himself  excessively  su- 
perior, with  his  conceptions  the  only  realities.  When 
this  is  carried  to  extremes,  with  attempt  to  live  it 
literally,  we  have  to  call  it  insanity  and  put  him 
away  to  save  him  from  himself. 

These  aberrations  may  also  be  induced  in  an  op- 
posite manner,  by  excessive  bullying,  suppression  or 
neglect,  which  likewise  cause  the  nature  to  strike 
in,  engendering  feelings  of  self-pity  and  self-love, 
which  also  exaggerate  the  ego,  and  invite  a  similar 
train  of  results.  It  is  evident  how  readily  minds  so 
handicapped  would  come  under  the  influence  of  the 
mechanisms  traced,  and  of  others  more  intricate 
which  give  the  derangement  its  particular  character. 
lUit  again  we  must  say  that  even  these  conditions 
are  merely  artificial,  without  endurance  of  their 
own,  and  with  the  discordant,  undisciplined  motives 
harmonized  or  controlled,  could  fade  and  clear  up 
which  they  frequently  do. 

Just  why  one  person  manifests  physical,  another 
nervous,  or  another  mental  disorder,  is  a  matter  of 
individual  circumstances  and  temperament,  but  mo- 
tives and  mechanisms  constitute  the  fabric,  with  ac- 
cident or  destiny  presenting  the  peg  to  hang  it  on. 
And  then  the  thinsj  becomes  a  habit,  a  working  com- 


PSYCHOPATHOLOGY  19 

promise,  for  one  at  bay  among  contending-  motives. 
Tt  becomes  an  outlet  for  other  feelings  kept  under 
pressure,  justifies  complaint,  and  warrants  sympa- 
thy, which  we  all  have  a  weakness  for,  and  even 
gives  purpose  to  otherwise  purposeless  lives.  In 
fact  the  ailment  may  become  a  pet,  and  be  cherished, 
coddled  or  revelled  in  accordingly,  with  correspond- 
ing reluctance  to  relinquish  it  and  get  well.  Para- 
dox perhaps,  yet  none  the  less  true,  for  the  fact  re- 
mains one  can  get  well  as  soon  as  the  desire  to  is 
single  and  unmixed. 

But  before  taking  up  the  question  of  healing  it 
will  be  expedient  at  this  point  to  insert  some  para- 
graphs on  sex,  a  subject  encumbered  with  much 
misinformation  and  morbid  feeling,  and  therefore 
pertinent  here. 

Sex,  or  rather  sexuality,  is  a  salient  element  in  the 
instinct  of  self-projection,  already  mentioned,  is  a 
form  of  energy  convertible  into  other  manifesta- 
tions, normal  or  abnormal,  and  is  now  known  to  be 
a  frequent  factor  in  the  problem  we  have  in  hand. 
Being  a  faculty  of  all  life,  it  is  incorporated  in  all 
living  things,  but  like  all  other  functions  it  has  to 
go  through  a  process  of  evolution  before  arriving 
at  maturity.  It  is  the  last  of  the  elementary  func- 
tions to  mature,  is  the  most  protracted  in  develop- 


20  PSYCH  OPATHOLOGY 

merit,  is  the  one  most  ignored,  can  make  the  most 
trouble,  and  for  this  and  other  reasons  is  normally 
hedged  in  by  the  greatest  amount  of  inhibition  and 
restraint. 

Sexual  indiscretion  may  blast  the  ultimate  vic- 
tim with  illegitimacy  or  worse,  the  immediate  vic- 
tim with  disease,  disgrace  or  both,  and  the  subject 
likewise,  as  well  as  with  demoralization  or  degen- 
eracy. So  that  the  instinctive  attitude  of  people  in 
general  is  properly  prudent,  conservative  and  even 
apprehensive.  There  are  also  other  grounds  for 
aversion  in  the  fact  that  the  expression  of  sex  is  in 
parts  of  the  body  inherently  offensive  and  giving 
most  shame,  and  that  in  this  connection  one  is  the 
most  vulnerable  to  ridicule  and  reproach. 

Since  the  function  is  not  matured  until  the  ao-e  of 

r*> 

twrelve  or  fifteen,  it  must  necessarily  pass  through 
stages  of  development  before  this.  Hence  it  is  seen 
to  manifest  imperfectly  at  earlier  periods,  awk- 
wardly and  incoherently  like  any  other  undeveloped 
function.  Sex-consciousness  and  sex-curiosity, 
though  perhaps  not  identified  as  such,  may  even  ap- 
pear at  the  unbelievable  age  of  eighteen  months. 
There  then  follow  innocent  or  shame-faced  attempts 
to  gratify  the  curiosity,  with  experiments  of  various 
indiscriminate  kinds,  all  of  which  can  take  place 


PS  YCHO  PATHOLOGY  21 

quite  spontaneously,  for  the  instinct  is  auto-genetic, 
grows  of  itself,  and  seduction  is  not  essential.  These 
experiments  and  investigations  may  be  personal, 
with  others,  either  sex,  old  or  young,  or  even  with 
other  creatures,  for  sex  is  universal  and  may  make 
any  appeal,  especially  at  this  period  of  great  sus- 
ceptibility and  imperfect  restraint. 

Yet  speaking  without  prejudice,  these  sponta- 
neous manifestations  are  not  necessarily  reprehen- 
sible, in  their  occasional  occurrence  entirely  harm- 
less, and  on  no  account  to  be  dealt  with  by  drastic 
intimidation  or  shaming,  which  may  have  an  op- 
posite effect  from  the  one  intended.  Masturbation, 
for  instance,  although  of  course  not  to  be  encour- 
aged, is  practically  universal  at  some  period  of  life, 
and  if  seriously  detrimental  nobody  would  be  sane 
or  sound.  We  place  the  emphasis  in  this  way  be- 
cause of  widespread  morbid  misconceptions  on  the 
subject,  and  of  course  do  not  here  refer  to  out-and- 
out  incorrigibles.  All  rightly  constituted  children 
have  sufficient  self-respect  of  their  own  to  restrain 
them,  even  without  outside  assistance,  and  besides 
the  process  is  naturally  self-limited. 

The  normal  child  growing  right  along,  mentally, 
morally  and  physically,  passes  through  these  evo- 
lutionary stages,  pausing  here  or  there  as  in  all 


22  PSYCHOPATHOLOGY 

growth,  but  with  the  instinct  steadily  focalizing,  and 
at  adolescence  ultimately  focused,  and  projected 
exclusively  and  with  due  restraint  toward  the  com- 
plementary sex.  This  is  the  normal  and  desirable, 
but  there  is  also  the  abnormal,  to  explain  which  t\vo 
other  factors  must  now  be  considered. 

In  the  first  place,  there  is  no  such  thing  as  pure 
type  of  anything,  and  this  applies  also  to  sex.  In 
early  gestation  the  embryo  is  indeterminate,  with 
structures  appearing  which  may  develop  into  either 
sex-apparatus,  or  both.  After  a  few  weeks,  how- 
ever, one  progresses  while  the  other  falls  back,  so 
that  the  child  is  finally  born  male  or  female,  but 
nevertheless  retains  in  its  body,  all  through  life, 
vestiges  of  organs,  which  if  developed,  would  con- 
stitute those  of  the  opposite  sex.  The  male  breast 
is  an  obvious  example,  of  which  there  is  a  complete 
set  of  others,  with  analogs  in  the  female.  The  sec- 
ondary sex  features  are  still  better  known,  such  as 
high  voice,  full  bust,  wride  hips  or  rounded  body  in 
some  men,  and  hairy  ness,  big  bones  or  muscular 
form  in  some  women.  Hence  anatomically  we  are 
a  blend,  potentially  either,  with  some  even  manifest- 
ing both  characteristics. 

Temperamentally  the  shading  is  also  observed,- 
vigorous,  aggressive  women,  and  tender,  gentle  men, 


PSYCHOPATHOLOGY 

to  say  nothing  of  mannish  women  and  effeminate 
men,  with  constitution  and  tendencies  to  correspond. 
Some  men  even  manifest  a  menstrual  period,  with 
or  without  sanguineous  effusion  from  some  mem- 
brane, as  well  as  change  of  life.  But  these  traits  do 
not  necessarily  match  each  other,  for  many  lovely 
womanly  women  are  found  in  unlovely  bodies,  while 
a  splendid  masculine  body  does  not  always  imply  a 
manly  man. 

And  now  we  can  conceive  of  deviations  in  the 
sphere  of  the  sex  instinct  itself.  Many  are  more  or 
less  naturally  inverted,  or  modified  in  this  respect, 
with  genuinely  homosexual  or  perverted  proclivities, 
and  many  may  easily  be  influenced  that  way,  in  the 
delicate,  unformed  period  of  childhood,  which  brings 
us  down  to  the  second  factor  in  this  problem,  name- 
ly the  psychology  of  sex,  within  and  without.  The 
function  is  very  far  from  being  a  mere  physical,  or 
so-called  animal  one,  for  it  is  most  intimately  per- 
meated, and  influenced  by  ideas,  and  by  the  psy- 
chological mechanisms  we  have  previously  dis- 
cussed, such  as  suggestion,  association,  dissociation 
and  others 

The  child  does  not  grow  up  in  solitude  and  sepa- 
rate, but  is  completely  environed  by  family,  associ- 
ates and  strangers,  all  imbued  with  various  attitudes 


24  PSYCHOPATHOLOGY 

in  this  matter,  which  they  may  be  only  too  ready 
to  impart  to  him.  Hence  his  own  development  is 
modified  or  distorted  by  this  outside  psychology,  as 
well  as  by  that  origirrating  within  him.  Shame, 
fear  or  abuse  may  cause  certain  propensities  to 
strike  in  and  take  deep  root,  which  if  unmolested 
would  have  dwindled  and  disappeared,  or  artificially 
suggested  charm  may  cause  pernicious  practices  to 
flourish,  which  otherwise  would  never  have  mani- 
fested. That  forbidden  fruit  seems  most  desirable 
is  always  true,  and  since  in  this  sphere  wre  are  more 
sensitive  than  in  any,  too  much  officiousness  may 
over-emphasize  some  phase,  and  give  it  too  much  in- 
terest with  results  to  be  regretted. 

The  problem  is  always  peculiarly  individual,  calls 
for  the  utmost  discretion  and  tact,  if  not  hands  off, 
while  mere  morbid  dread  is  never  in  order.  Respect- 
ful confidence,  with  enlightenment  where  needed,  is 
the  best  generalization  on  the  management  of  child- 
ren. \Ve  have  here  to  deal  with  an  energy,  which  if 
throttled  at  one  point  is  liable  to  find  exit  at  another 
less  desirable,  so  that  our  best  course  is  to  inspire 
transformation  into  other  activities  of  true  worth 
and  genuine  appeal.  This  process,  known  as  trans- 
mutation, or  sublimation,  is  quite  possible,  for  in  it 
the  purely  sexual  functions  become  dormant  or  la- 


PSYCH O PATHOLOGY 

tent,  just  as  the  woman's  breast  is  dormant  when 
not  engaged  in  lactation.  To  be  truly  successful, 
however,  there  must  be  a  genuine  inspiration  or 
motive,  which  prompts  to  some  definite  activity,  for 
mere  arbitrary  repression  results  in  blighting  and 
deireneracv,  though  many  choose  this  negative 

o  o 

course  rather  than  incur  the  risks  and  responsibili- 
ties of  actual  function. 

Some  sexual  manifestations  are  properly  regard- 
ed as  beyond  the  limit,  namely  those  that  are  in- 
cestuous, homosexual,  with  animals,  or  otherwise 
grossly  perverted,  and  these  if  persistent,  place  the 
subject  at  serious  disadvantage  with  society,  or  if 
artificially  repressed  make  for  intolerable  distrac- 
tion, which  exposes  the  victim  to  the  various  patho- 
logical mechanisms  detailed.  The  wisest  procedure 
would  be  rational  transformation  of  the  abnormal 
impulse,  which  in  a  great  many  cases  is  possible, 
and  which  now  brings  us  down  to  the  practical  con- 
sideration of  healing. 

Realizing  more  fully  the  real  nature  of  disease 
and  disorder,  which  in  so  many  cases  is  merely  a 
compromise  of  morbid  suggestion,  repressed  emo- 
tion and  fear,  exerting  unfavorable  effects  on  mind 
and  body,  we  are  better  equipped  for  solution  of  the 
problem  and  restoration  to  normal. 


26  PSYCHOPATHOLOGY 

The  inherent  tendency  of  all  life  is  to  renew  itself 
and  continue  living,  and  therefore  the  faculty  of 
healing  or  recovering  permeates  all  living  things. 
Hence  it  usually  takes  place  spontaneously  and 
merely  needs  to  be  allowed  to  act.  But  there  may 
be  inertia  or  obstacles  to  healing,  when  we  work  to 
provoke  it  by  reaction,  or  to  remove  the  obstacles 
and  make  conditions  favorable.  And  since  the 
measures  employed  are  so  numerous,  and  become 
not  infrequently  an  element  in  the  disorder,  it  seems 
proper  at  this  point  to  review  them. 

Beginning  with  the  most  radical,  there  is  surgery, 
urgent  and  indispensable  in  injuries,  infection  and 
deformities,  but  seldom  advisable  otherwise.  The 
practice  of  surgery  has  long  been  conducted  as  well 
as  is  humanly  possible,  so  that  true  progress  would 
now  consist  in  making  it  unnecessary. 

Medicine  comes  next  and  has  a  place.  The  value 
of  agents  for  the  urgent  relief  of  pain,  emergency 
stimulation,  purgation,  as  antidotes  to  poisons  and 
for  other  temporary  purposes  is  obvious,  but  beyond 
this  their  use  is  decidedly  slight  and  often  repre- 
hensible, though  the  suggestive  effect  is  occasional- 
ly remedial.  The  same  is  true  of  the  various  light 
and  electrical  applications,  while  few  of  the  serums 
have  fulfilled  their  promise. 


PSYCHOPATHOLOGY  27 

The  manipulative  methods  of  osteopathy  and  chi- 
ropractic are  more  rational.  To  the  average  pa- 
tient they  are  without  risk  of  harm,  and  by  relaxing 
or  adjusting  the  neuro-muscular  tension  which  ex- 
ists in  all  disorders,  definite  relief  may  be  afforded 
which  can  result  in  ultimate  recovery.  This  is  also 
the  virtue  of  the  hydropathic  and  heat  methods. 

The  various  dietetic  systems  are  not  to  be  taken 
too  seriously.  In  constitution  \ve  are  omniverous 
and  equipped  with  the  organs  and  functions  to  di- 
gest and  be  nourished  by  food  of  any  reasonable 
quality,  quantity  and  variety,  all  of  which  are  de- 
sirable in  a  state  of  health.  In  special  conditions 
special  dietetic  regulations  are  indicated,  though 
one's  owrn  personal  experience  is  the  best  guide. 

Hypnotism  is  a  therapeutic  measure  to  be  classed 
with  the  undesirable  ones  of  medicine  and  surgery. 
It  is  occasionally  the  only  resort,  but  is  seldom  ef- 
fective where  most  needed,  and  cannot  fail  to  stul- 
tify in  some  respect  though  not  necessarily  perma- 
nently. 

Suggestion  and  auto-suggestion  are  at  work  all 
the  time  anyway,  and  since  we  are  practically  free 
to  choose,  we  would  better  select  suggestions  which 
help,  rather  than  the  adverse  sort.  Literature  and 
modern  philosophy  in  general,  to  say  nothing  of 


28  PSYCH  OPATHOLOGY 

special  New-thought  and  Christian  Science  utter- 
ances, fairly  teem  with  conceptions  of  merit, 
strength  and  uplift  of  which  it  were  certainly  wise 
to  avail  oneself. 

Metaphysical  and  faith  healing-  are  realities  many 
times,  and  it  is  not  scientific  to  ignore  them,  nor 
those  certain  rare  souls,  often  humble  and  untu- 
tored, who  seem  to  be  natural  healers.  For  it  is  en- 
tirely possible  for  some  effective  concept  feeling, 
from  whatever  source,  to  penetrate  into  the  sub- 
conscious, and  there  discharge  or  neutralize  the 
basic  strains  responsible  for  the  disorder. 

But  any  or  all  of  these  measures  may  fail,  even  in 
curable  cases,  so  to  show  how  the  problem  may  still 
be  solved,  we  must  proceed  further.  It  is  of  course 
presumed  that  in  a  given  case  all  the  physical  re- 
quirements are  being  met,  for  these  are  well  kno\vn 
and  there  is  no  excuse  for  omission  when  available. 
But  we  nowr  knowT  how  important  the  psychological 
factors  are,  and  can  understand  how  such  obstruc- 
tions may  prove  more  obstinate. 

To  begin  with  there  are  certain  general  miscon- 
ceptions, or  pathological  superstitions,  which  when 
entertained  can  act  as  deterrents  to  recovery,  and 
these  should  be  disposed  of  at  once. 

The   first   is   that   concerning  the   ominousness  of 


PSYCHOPATHOLOGY  29 

heredity,  which,  as  a  matter  of  fact  is  practically  a 
negligible  factor  in  disease.  Syphilis  is  the  only 
decided  taint  that  can  be  inherited,  and  even  its  ef- 
fects can  be  mitigated.  But  of  course  there  is  a 
law  of  heredity  by  which  we  derive  likenesses,  dis- 
position, constitution  and  temperament,  and  if  our 
forbears  reacted  to  conditions  with  a  disease  com- 
promise, we,  by  making  a  like  faulty  adjustment, 
would  probably  manifest  similar  disorder.  But  the 
heredity,  so  far  as  the  disorder  is  concerned,  is  ap- 
parent, not  real,  and  no  obstacle  to  recovery  when 
the  right  course  is  pursued. 

Prenatal  influence  is  another  factor  to  which  a 
great  deal  of  undue  weight  is  given.  Although  it 
occasionally  manifests  in  quite  startling  ways,  this 
is  far  less  frequently  than  supposed,  and  conditions 
presumed  to  be  fixed  by  prenatalism  have  repeated- 
ly been  corrected. 

No  disease  should  be  regarded  as  an  entity  in 
itself,  for  it  is  either  a  reaction  to,  or  compromise  of 
opposing  forces,  and  has  no  endurance  of  its  own. 
Acute  diseases  are  simply  nature's  resistance  to  con- 
tamination, and  signify  active  vitality  making  its 
fight,  while  chronic  or  functional  disorder  is  an  un- 
necessary compromise  of  the  conflict. 

There   is   no   irreplaceable   wearing  out  of  tissue 


30  PSYCHOPATHOLOGY 

when  subjected  to  the  strains  considered.  There 
may  be  temporary  reduction  in  vitality,  but  when 
the  right  chord  is  struck  the  response  will  be  vig- 
orous, perhaps  better  than  ever. 

The  duration  of  an  ailment  bears  but  a  minor 
relation  to  the  time  required  for  recovery.  Persons 
sick  for  twenty  years  have  been  known  to  get  well 
in  twenty  minutes  when  the  right  thing  was  done. 

The  menopause  or  change  of  life  need  not  be  a 
critical  time  for  anyone.  Certain  predispositions 
sometimes  emerge  at  this  period,  but  it  does  not 
prevent  correction,  and  in  no  case  need  any  trouble 
be  anticipated. 

Xervous  disorders  have  nothing  to  do  with  the 
nerves  themselves  which  in  such  cases  are  always 
normal.  The  words  nervous  and  nervousness  are 
used  to  describe  the  condition  of  the  person  affected, 
but  there  is  no  change  or  deterioration  in  the  actual 
nerves. 

Nor  do  mere  nervous  affections  ever  merge  into 
insanity. 

At  this  point,  believing  them  of  definite  value  in 
the  problem  of  keeping'  well,  the  writer  ventures  the 
following  recommendations  :- 

Care  for  your  physical  body  in  all  respects, — food, 
clothing,  shelter,  rest,  exercise  and  function,  and  do 


PSYCHOPATHbL'bG-Y-  31 


not  endure  detrimental  conditions  when  you  do  not 
have  to. 

Do  not  practice  persistent  self-repression. 

Realize  things  for  just  what  they  are.  Realiza- 
tion need  not  imply  action,  for  attitude  and  conduct 
are  two  different  things,  and  you  can  realize  much 
without  taking  any  action,  but  an  artificial  attitude 
will  eventually  break  you.  The  realization  will  not 
prove  so  bad  anyway. 

Keep  yourself  \vell-nourishecl  mentally. 

Be  honest  with  yourself. 

But  perhaps  mere  generalities  will  not  suffice, 
and  the  harrassed,  desperate  patient  requires  per- 
sonal assistance.  Successful,  permanent  healing 
will  then  involve  three  things, — a  frank,  unburden- 
ing analysis  of  the  exact  nature  of  the  disorder,  sat- 
isfying enlightenment  on  all  troublesome  points, 
and  a  wholesome  readjustment  on  a  sane,  sound 
basis.  This  is  the  gist  of  the  entire  matter,  but  as 
between  patient  and  healer,  certain  special  condi- 
tions are  also  important. 

First  there  must  be  what  is  called  rapport,  or  a 
reasonable  degree  of  confidence,  understanding,  or 
willingness  to  meet  on  the  case.  Next  the  method 
of  treatment  must  be  followed  conscientiously,  and 
finally  there  must  take  place  that  subtle,  indefinable, 


"32  PSYCHOPATHOLOGY 

but  conclusive  process,  tentatively  called  "trans- 
ference," which  cannot  be  coerced,  but  which  fol- 
lows automatically  when  the  other  factors  favor, 
and  by  which  the  cure  is  made. 

Perfected  methods  of  word-association,  dream- 
analysis  and  study  of  the  constant  little  mechan- 
isms of  manner,  speech  and  bearing  reveal  all  the 
tensions  and  stresses  of  the  subject,  and  point  the 
way  to  their  discharge.  So  that  a  short  series  of 
interviews,  in  which  the  various  complexes  are 
given  full  utterance,  is  ordinarily  sufficient  to  dissi- 
pate the  symptoms  and  secure  restoration  to  nor- 
mal. 


N 


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